Provider Demographics
NPI:1376936146
Name:LEE, HYE YOUNG
Entity Type:Individual
Prefix:
First Name:HYE YOUNG
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20210 42ND AVE
Mailing Address - Street 2:APT1A
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11361-1874
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:20210 42ND AVE
Practice Address - Street 2:APT1A
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11361-1874
Practice Address - Country:US
Practice Address - Phone:917-575-1845
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-18
Last Update Date:2015-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY531127163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse